Enrolment Form

Student’s Name
Date of Birth
Parent / Carer Name
Address
Post Code
Home Phone Number
Email Address

Emergency Contact 1

Name
Relationship
Phone Number

Emergency Contact 2

Name
Relationship
Phone Number

Specific Medical Requirements
Previous Dance Experience
Classes to Enrol In

Permissions & Agreements

I acknowledge that I am totally responsible for my child’s safety at all times other than their timetabled lessons such as during gaps between lessons or if I am late collecting them.

Name
Relationship
Signature
Date

I am / am not happy for my child to be corrected through physical contact.

Name
Relationship
Signature
Date

I am / am not happy for my child to take part in Dare Dance Academy shows, which may be recorded for distribution to parents and friends.

Name
Relationship
Signature
Date

I am / am not happy for my child photograph to be used for promotional work.

Name
Relationship
Signature
Date